This condition is one of the most difficult and controversial issues in obstetrics and gynecology. A Luteal Phase Defect (LPD) can prevent the onset and development of pregnancy, but there is no consensus on what to do if it’s present during pregnancy [1].
What is LPD?
The luteal phase is the latter phase of the menstrual cycle. After ovulation (the release of the egg from the follicle), the endometrium (uterine lining) thickens to prepare for the implantation of the fertilized egg. The corpus luteum (a hormone-secreting body in the ovary) then produces progesterone, which prepares the endometrium for implantation. If the corpus luteum does not produce enough hormones and the uterine lining does not thicken, implantation cannot occur, and neither can pregnancy.
In a typical cycle, the average length of the luteal phase is between 12 and 14 days. However, in some women, the phase may be shorter. If menstruation comes less than 10 days after ovulation, it may be an indication of luteal phase deficiency [2].
What shortens the luteal phase?
The mechanism is not fully understood, but we do know that luteal phase deficiency is more common in women with impaired egg maturation due to hormonal disorders. But even if a woman with a short luteal phase ovulates, she may not produce enough progesterone afterward to become pregnant. On the other hand, there are women with a short luteal phase who conceive on their own without any issues and may never be aware of the fact that they have an atypical menstrual cycle [2].
Can or should I treat an LPD if I’m trying to get pregnant?
Yes. Your doctor may prescribe medications that compensate for the lack of hormones produced naturally. These regulate your menstrual cycle, ensuring ovulation and the thickening of the endometrium [3]. If pregnancy occurs during hormone therapy, it’s important to continue treatment until the placenta is formed (between weeks 15-20).
What if I get pregnant without hormone therapy?
A typical healthy pregnancy occurs without the outside aid of hormones, so if you’ve had previous treatment for an LPD and become pregnant after treatment is finished, you can consider your pregnancy typical and take all the usual steps to stay healthy.
However, if you become pregnant with the use of assisted reproductive technology ( ART ), after prolonged infertility, or during any treatment, medical support may be required [1]. Consult your doctor for the best course of action.
How do LPD medications work?
These medications contain progesterone and are taken in the second half of the menstrual cycle. They ensure a biphasic (two-phase) menstrual cycle and make pregnancy possible [4].
What are the side effects?
Drugs to support the luteal phase can cause drowsiness, dizziness, insomnia , vaginal discharge , high blood pressure , and minor edema (swelling). They are taken only in the first trimester and at the beginning of the second, always under a doctor’s supervision.
